Editing Intramuscular injection (section)

==Uses==
Intramuscular injection is commonly used for medication administration. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the [[first pass metabolism]] which occurs with oral administration.<ref>{{Citation|last=Saxen|first=Mark A.|title=Chapter 17 – Pharmacologic Management of Patient Behavior|date=2016-01-01|url=http://www.sciencedirect.com/science/article/pii/B978032328745600017X|work=McDonald and Avery's Dentistry for the Child and Adolescent (Tenth Edition)|pages=303–327|editor-last=Dean|editor-first=Jeffrey A.|place=St. Louis|publisher=Mosby|language=en|doi=10.1016/b978-0-323-28745-6.00017-x|isbn=978-0-323-28745-6|access-date=2020-11-25|url-access=subscription}}</ref> The medication may not be considered 100% [[bioavailability|bioavailable]] as it must still be absorbed from the muscle, which occurs over time.<ref name="Clin pharm">{{cite book |last1=Spruill |first1=William |last2=Wade |first2=William |last3=DiPiro |first3=Joseph T. |last4=Blouin |first4=Robert A. |last5=Pruemer |first5=Jane M. |title=Concepts in clinical pharmacokinetics |date=5 March 2014 |publisher=American Society of Health-System Pharmacists |location=Bethesda, MD |isbn=978-1-58528-387-3 |edition=Sixth}}</ref>{{rp|102–103}} An intramuscular injection is less invasive than an intravenous injection and also generally takes less time, as the site of injection (a muscle versus a vein) is much larger. Medications administered in the muscle may also be administered as [[depot injection]]s, which provide slow, continuous release of medicine over a longer period of time.<ref name=Wright>{{cite book |last1=Wright |first1=Jeremy C. |last2=Burgess |first2=Diane J. |title=Long acting injections and implants |date=29 January 2012 |publisher=Springer |isbn=978-1-4614-0554-2 |page=114}}</ref> Certain substances, including [[ketamine]], may be injected intramuscularly for [[recreational drug use|recreational]] purposes.<ref>{{cite journal |last1=Lankenau |first1=SE |last2=Clatts |first2=MC |title=Drug injection practices among high-risk youths: the first shot of ketamine. |journal=Journal of Urban Health: Bulletin of the New York Academy of Medicine |date=June 2004 |volume=81 |issue=2 |pages=232–48 |doi=10.1093/jurban/jth110 |pmid=15136657|pmc=1852476 }}</ref> Disadvantages of intramuscular administration include skill and technique required, pain from injection, anxiety or fear (especially in children), and difficulty in self-administration which limits its use in [[Outpatient clinic (hospital department)|outpatient medicine]].<ref name=Polania />

[[Vaccine]]s, especially [[inactivated vaccine]]s, are commonly administered via intramuscular injection.<ref name="Nurs2015">{{cite journal |last1=Sisson |first1=Helen |title=Aspirating during the intramuscular injection procedure: a systematic literature review |journal=Journal of Clinical Nursing |date=September 2015 |volume=24 |issue=17–18 |pages=2368–2375 |doi=10.1111/jocn.12824|pmid=25871949 |url=https://hull-repository.worktribe.com/373009/1/Article.pdf }}</ref> However, it has been estimated that for every vaccine injected intramuscularly, 20 injections are given to administer drugs or other therapy.<ref name="Nurs2015" /> This can include medications such as [[antibiotic]]s, [[immunoglobulin]], and [[hormone]]s such as testosterone and [[medroxyprogesterone]].<ref name="Polania">{{cite journal |vauthors=Polania Gutierrez JJ, Munakomi S |title=Intramuscular Injection |date=January 2020 |journal=StatPearls [Internet] |pmid=32310581 |url=https://www.ncbi.nlm.nih.gov/books/NBK556121/}}</ref> In a case of severe allergic reaction, or [[anaphylaxis]], a person may use an [[epinephrine (medication)|epinephrine]] [[autoinjector]] to self-administer epinephrine into the muscle.<ref>{{cite web|last=Mylan Specialty L.P.|title=EPIPEN®- epinephrine injection, EPIPEN Jr®- epinephrine injection|url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019430s053lbl.pdf|publisher=FDA Product Label|access-date=22 January 2014|url-status=live|archive-url=https://web.archive.org/web/20140201150929/http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019430s053lbl.pdf|archive-date=1 February 2014}}</ref>